| NPI | 1700303294 |
|---|---|
| Former Name | JENNA GRACE WILGING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: OH OTA006205) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: OH 006205) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2017-08-24 |